Provider Demographics
NPI:1629042155
Name:PATEL, NAYNESH R (MD)
Entity Type:Individual
Prefix:
First Name:NAYNESH
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4172 INDIAN RIPPLE RD STE A
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3286
Mailing Address - Country:US
Mailing Address - Phone:937-431-3779
Mailing Address - Fax:937-431-3776
Practice Address - Street 1:4172 INDIAN RIPPLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-3285
Practice Address - Country:US
Practice Address - Phone:937-431-3779
Practice Address - Fax:937-431-3776
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35057996P207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2015438Medicaid
OH2015438Medicaid
OHPA0675946Medicare PIN